tbuckley/cabot-search huggingface dataset:
Bedside Diagnosis
Authors: William R. Best
Journal: JAMA (1986)

A rational approach to diagnosis is to decide which of a patient's signs and symptoms is most significant, then to key subsequent investigation to this. That this is also a useful approach is attested to by the continued popularity of this work, which has survived in 12 editions over 36 years and has been translated into at least five other languages. Periodic revisions are necessary to reflect newer diagnostic modalities as well as evolving knowledge about disease. Nonetheless, directed questioning and careful physical examination of the patient continue to be seen as critical elements in diagnosis. Incidentally, the word "bedside" in the book's title is perhaps misleading; the principles covered apply equally to office diagnosis, and methods beyond the history and physical examination are also considered. Pain of various sorts is given greater coverage than any other symptom, accounting for a fourth of the material. Abdominal pain is nicely divided
Anaphylaxis from alphazurine 2G during lymphography
Authors: W. L. Kopp
Journal: JAMA (1966)

ALPHAZURINE 2G, a blue triphenylmethane dye, has recently been used for two clinical purposes. Radiologists have injected it subcutaneously into patients to identify lymphatic vessels for lymphography.<sup>1</sup>Since the dye stains only viable tissues, surgeons have injected it intravenously into patients with severe burns to guide debridement.<sup>2,3</sup> To date, only one adverse reaction to alphazurine 2G has been reported.<sup>4</sup>A burned patient who received 6 ml of a 10% solution of alphazurine 2G intravenously suffered immediate sneezing, respiratory distress, shock, convulsions, and temporary cardiac arrest. He died five days later. On the other hand, recent reviews<sup>5,6</sup>of experiences with lymphography have not mentioned adverse reactions from the dye, which was used to identify lymphatic vessels. The present paper describes the occurrence of nonfatal, anaphylactic reactions to alphazurine 2G in two patients during lymphography. <h3>Report of Cases</h3><h3>CASE 1.—</h3> A 56-year-old cheese maker was well until early
Risk of subsequent thromboembolism for patients with pre-eclampsia
Journal: BMJ (2003)

inclusion bodies, vacuoles, degenerating nuclei, or showing naked nuclei may be seen in infected marrow. 14In most patients we found no evidence of disseminated intravascular coagulation.The postmortem findings of active bone marrow with normal megakaryoctes in patients with thrombocytopenia favour an immune cause of thrombocytopenia.A major side effect of ribavirin is reversible haemolytic anaemia. 15 16About 60% of our patients who received ribavirin experienced a drop of haemoglobin of more than 20 g/l.Despite this high drop, ribavirin was well tolerated and none of the patients needed withdrawal of treatment or transfusion.The development of anaemia may be a cause for concern.None the less haemolysis was transient, and haemoglobin counts improved after treatment with ribavirin had been completed in all cases.Careful monitoring of haemoglobin is advisable for patients who receive ribavirin. ConclusionsLymphopenia, in particular T lymphopenia, was common among patients with SARS in our study.A notable drop in CD4 and CD8 lymphocyte counts occurred early in the course of the syndrome and was associated with adverse outcomes.Thrombocytopenia, neutrophilia, and transient prolonged activated partial thromboplastin time were other common findings.Further studies to evaluate the mechanisms of these manifestations may help us to understand this disease.We thank the Haematology Division of the Department of Anatomical and Cellular Pathology for their full support in the laboratory investigations.Contributors: JJYS is guarantor and
AB0021 Identification of novel acpa targets in rheumatoid arthritis synovial tissues using 2d gel electrophoresis and mass spectrometry.
Authors: E. Ossipova, G. Oliynyk, C. Cerqueira, S. Becker, J. Ytterberg, G. Auer, L. Klareskog, P.-J. Jakobsson
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Rheumatoid arthritis (RA) is an inflammatory autoimmune disease characterised by synovial joint inflammation and pannus formation that leads to degradation of cartilage and the underlying bone. Presence of anti-citrullinated protein/peptide antibodies (ACPA) in 60-70% of patients with RA is one of the major characteristics of the disease and associates with a more aggressive disease course, suggesting a direct pathogenic involvement of ACPA in disease initiation and progression. ACPA recognizes several citrullinated proteins like fibrinogen, α-enolase, vimentin, and collagen II. <h3>Objectives</h3> In present study, we aim for the identification of novel ACPA targets in synovial tissues of patients with RA. <h3>Methods</h3> RA synovial tissues were obtained from patients undergoing joint replacement surgery for rheumatoid arthritis of the knee or elbow at the Karolinska University Hospital, Stockholm, Sweden. Synovial tissues were frozen in liquid nitrogen shortly after resection and stored at -80°C. All procedures were approved by Northern Stockholm Ethical Review Board and tissues were obtained with informed patient consent. Proteins, extracted from pulverised frozen synovial tissues and solubilized in lysis buffer, were resolved in 2D PAGE. Separated proteins were directly transferred to a nitrocellulose membrane and probed with human ACPA pool obtained using CCP2 affinity columns, kindly provided by Euro-Diagnostica, as described previously<sup>1</sup>. Human IgG and CCP2 flow-through fraction were used as control antibodies. Silver stained gel spots, corresponding to WB signals, were extracted from 2D gels, in-gel digested using Lys-C, and resulting peptides/proteins were identified using mass spectrometry. <h3>Results</h3> By combining 2D gel electrophoresis with mass spectrometry, we have identified several novel potential ACPA targets as well as already characterized proteins. It remains to demonstrate if these proteins are citrullinated. <h3>Conclusions</h3> Here we demonstrate an extensive ACPA reactivity against novel proteins in RA synovial membranes. The results encourage further exploration of the role of these proteins/peptides in rheumatoid arthritis both as additional biomarkers as well as their potential roles in the pathogenesis of RA. <h3>References</h3> <b>Ossipova E</b>, Cerqueira C, Reed E, <i>et al</i>. Affinity purification and characterization of anti-citrullinated protein/peptide antibodies from plasma and synovial fluids of patients with rheumatoid arthritis <i>(submitted).</i> <h3>Disclosure of Interest</h3> None Declared
Roentgenographic documentation of the Mallory-Weiss syndrome
Authors: M. Sparberg
Journal: JAMA (1968)

The Mallory-Weiss syndrome is responsible for 5% to 10% of cases of gastrointestinal hemorrhage. The diagnosis is suspected clinically and documented by endoscopy or at surgery. Except in one reported instance, roentgenographic studies uniformly have been negative. In two cases of severe, deep emetogenic lacerations of the distal esophagus, the lesions were sufficiently large to be detected on barium swallow. The lesions also were seen at endoscopy and confirmed surgically in both cases.
Abstract P106: Dietary Patterns and Incidence of Atrial Fibrillation: the Health Professionals Follow-up Study (HPFS)
Authors: Shadi Kalantarian, Fumiaki Imamura, Martin Lajous, Eric Rimm, Frank Hu, Walter Willett, Dariush Mozaffarian
Journal: Circulation (2012)

Introduction: Atrial fibrillation (AF) is a growing public health problem. Overall diet quality has proven informative for studying chronic diseases, but potential relations with AF risk are unknown. Methods: We followed 39,840 US male health professionals free from AF at baseline (age 70.5±9.8 y) for incidence of AF from 2002 to 2010. Diet was assessed every 4 ys by validated questionnaires, with cumulative updating of past diet. We also performed analyses evaluating only more recent diet. A diet pattern was characterized based on biologic considerations using 8 dietary factors that might influence risk factors for AF: higher fruits, vegetables, whole grain, seafood, nuts, and polyunsaturated to saturated fat ratio, and lower glycemic load and trans-fat. Each factor was scored in quintiles (1- 5), in ascending order for more healthful factors and descending order for less healthful factors. These scores were summed to quantify the diet pattern score (range 8-40). Incident AF was identified from initial self-report that was also subsequently confirmed by detailed supplementary questionnaire; these methods were validated against medical records in a subset (positive predictive value=95%). We estimated risk using Cox models adjusting for age, prevalent diseases, lifestyle habits, and health-seeking behaviors (greater multivitamin use; more routine physical, sigmoidoscopy, and rectal exams). Results: During 308,144 person-years follow-up, 879 incident AF cases occurred. Men with higher diet scores were older, less likely to smoke, more likely to be physically active and be on aspirin, and more likely to have health seeking behaviors. The multivariable-adjusted HR (95%CI) for quintiles 2 to5 vs. quintile 1 were 1.06 (0.84, 1.33), 1.04 (0.82, 1.32), 1.15 (0.92, 1.45), and 1.26 (0.98, 1.60), respectively (p trend=0.04). Exploring each of the 8 dietary factors individually, none were significantly associated with incident AF, except seafood which was inversely associated (HR for quintile 5 vs. 1=0.79; 95%CI=0.63, 1.00). Health-seeking behaviors were associated with trend toward AF risk (extreme quartile HR 1.21, 95% CI 0.92-1.59). Stratified by health seeking behavior, the diet score showed positive association with AF only in men with greatest health seeking behaviors (p trend 0.01), but not in the other groups (p&gt;0.8). Sensitivity analyses using only more recent diet, stratifying by aspirin use, or limiting to symptomatic AF cases did not appreciably alter results. Conclusions: Contrary to our hypothesis, a more healthful diet pattern was linked to higher AF risk. This association might partly relate to unmeasured or residual confounding due to greater health seeking behaviors that could increase AF diagnosis. Overall, our novel findings suggest no major benefits of a generally healthy diet on AF incidence, except perhaps for seafood consumption.
LONDON LETTER.
Journal: JAMA (2005)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Portuguese Society of Digestive Endoscopy: publications
Journal: Endoscopy (2008)

The Portuguese Society of Digestive Endoscopy (SPED), set up in 1979, is a scientific society for doctors and other professionals working with or interested in Digestive Endoscopy. Its objectives include promoting the development of Digestive Endoscopy at the service of health in Portugal and the dissemination of knowledge and research in this field. SPED also seeks to further national and international exchanges between professionals, implement standards of training and practice in Digestive Endoscopy, and promote educational initiatives for doctors and other technicians.
Esophageal obstruction by water-insoluble medication
Authors: A. J. Cummins
Journal: JAMA (1966)

<h3>To the Editor:—</h3> All physicians are painfully aware of the potentially hazardous effects of the flood of new drugs being released by the pharmaceutical industry. Most of these dangers lie in toxic pharmacologic action of the drugs or allergic reactions to them. The present report is of a mechanical hazard involved in esophageal obstruction from a relatively new "sustainedaction" form of pentaerythritol tetranitrate ( Peritrate—SA). <h3>Case Report:—</h3> A 62-year-old man, a police guard, was admitted to the hospital because of sudden severe dysphagia of 24 hours' duration. He was unable to swallow solid food, liquids, or saliva and regurgitated them freely and promptly. The severe dysphagia had begun in the morning and he remembered eating a normal meal the night before and also (but only recalled later) taking a "new heart pill" which a physician had recently prescribed for him. Three years previously he had had a subtotal gastrectomy and gastrojejunostomy
Monograph: Cancer Registration and Survival in California
Journal: JNCI Journal of the National Cancer Institute (1964)

Journal Article Monograph: Cancer Registration and Survival in California Get access JNCI: Journal of the National Cancer Institute, Volume 32, Issue 1, January 1964, Page 267, https://doi.org/10.1093/jnci/32.1.267 Published: 01 January 1964
Therapeutic Colonoscopy
Authors: A. Montori, G. Viceconte, G. Miscusi, G. Viceconte, C. Pastorino
Journal: Endoscopy (1976)

The authors report their experience with regard to operative fibrecolonoscopy both in routine and emergency cases. After taking into consideration the use of this technique for the study and treatment of rectal and colonic polyps, they also recommend the use in emergency conditions of colonic haemorrhage and in the removal of foreign bodies. They conlcude that therapeutic colonoscopy must be recognised as one of the most useful methods of diagnosis and treatment of some lesions of the rectum and colon.
ASSOCIATION NEWS.
Authors: Wm. B. Atkinson
Journal: JAMA (1896)

<h3>Second Pan-American Medical Congress.</h3> Philadelphia, Pa., May 23, 1896. <h3>To the Editor:</h3> Please announce to the profession that it is important for all who propose to attend the Second Pan-American Medical Congress to be held in the City of Mexico, Nov. 16 to 19, 1896, to inform me early in order that arrangements may be made with the railroads for transportation, and that the Secretary in Mexico may be properly informed as to the number likely to attend. It is necessary to have full information three months in advance, in order to arrange with the railroads. I will shortly send you a form for the certificate to issue to those who desire to go as delegates. I think also it will be well for me to issue a general circular to the societies urging them to appoint delegates. I am glad to announce that I have received replies from Senator
Expression of the endoplasmic reticulum molecular chaperone (ORP150) rescues hippocampal neurons from glutamate toxicity
Authors: Yasuko Kitao, Kentaro Ozawa, Mayuki Miyazaki, Michio Tamatani, Tomohiro Kobayashi, Hideki Yanagi, Masaru Okabe, Masahito Ikawa, Tetsumori Yamashima, David M. Stern, Osamu Hori, Satoshi Ogawa
Journal: Journal of Clinical Investigation (2001)

A series of events initiated by glutamate-receptor interaction perturbs cellular homeostasis resulting in elevation of intracellular free calcium and cell death. Cells subject to such environmental change express stress proteins, which contribute importantly to maintenance of metabolic homeostasis and viability. We show that an inducible chaperone present in endoplasmic reticulum (ER), the 150-kDa oxygen-regulated protein (ORP150), is expressed both in the human brain after seizure attack and in mouse hippocampus after kainate administration. Using mice heterozygous for ORP150 deficiency, exposure to excitatory stimuli caused hippocampal neurons to display exaggerated elevation of cytosolic calcium accompanied by activation of μ-calpain and cathepsin B, as well as increased vulnerability to glutamate-induced cell death in vitro and decreased survival to kainate in vivo. In contrast, targeted neuronal overexpression of ORP150 suppressed each of these events and enhanced neuronal and animal survival in parallel with diminished seizure intensity. Studies using cultured hippocampal neurons showed that ORP150 regulates cytosolic free calcium and activation of proteolytic pathways causing cell death in neurons subject to excitatory stress. Our data underscore a possible role for ER stress in glutamate toxicity and pinpoint a key ER chaperone, ORP150, which contributes to the stress response critical for neuronal survival.
Tribute
Authors: Barbara Hasko Curry
Journal: Annals of Internal Medicine (1993)

On Being a Doctor1 July 1993TributeBarbara Hasko Curry, MDBarbara Hasko Curry, MDDeaconess Medical Center, Billings, MT 59107.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-1-199307010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A physician has an encounter with a patient who has recently suffered a tremendous personal loss. The physician treats the patient and in so doing explores the rationale for and consequences of empathetic participation in the grieving process.It was a gloomy daydreary, sullenin contrast to the previous night's Independence Day celebration. There was sadness in the department, too; everyone had seen the news splashed across the morning paper. Her body had been found. I doubt there was anyone who was not affected by this tragedy. When one of the nurses told me that her mother was here, I didn't ... Author, Article, and Disclosure InformationAffiliations: Deaconess Medical Center, Billings, MT 59107.Corresponding Author: Barbara Hasko Curry, MD, 1751 Oak Ridge Lane, Billings, MT 59102. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUntaming Grief ? For Palliative Care Physicians 1 July 1993Volume 119, Issue 1Page: 86KeywordsChartsEmergency departmentEmotionsHeartNursesPatientsSleep Issue Published: 1 July 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Endometriosis
Authors: Cynthia Farquhar
Journal: BMJ (2007)

Endometriosis is a chronic condition characterised by growth of endometrial tissue in sites other than the uterine cavity, most commonly in the pelvic cavity, including the ovaries, the uterosacral ligaments, and pouch of Douglas (fig 1).⇓ Common symptoms include dysmenorrhoea, dyspareunia, non-cyclic pelvic pain, and subfertility (table 1).⇓ The clinical presentation is variable, with some women experiencing several severe symptoms and others having no symptoms at all. The prevalence in women without symptoms is 2-50%, depending on the diagnostic criteria used and the populations studied.1 The incidence is 40-60% in women with dysmenorrhoea and 20-30% in women with subfertility.w1-w3 The severity of symptoms and the probability of diagnosis increase with age.w4 The most common age of diagnosis is reported as around 40, although this figure came from a study in a cohort of women attending a family planning clinic.w5 Symptoms and laparoscopic appearance do not always correlate.2 The American Society for Reproductive Medicine has published a classification of severity of endometriosis at laparoscopy.w6 View this table: Table 1 Common presentations of endometriosis Fig 1 Mild pelvic endometriosis seen at the time of diagnostic laparoscopy. Arrows show typical endometriotic deposits (reproduced with permission from Dr D A Hill) #### Summary points ##### Medical treatment ##### Surgical treatment ##### Recurrences
Withdrawal of Mr. Hawes's Bill
Journal: BMJ (1841)

That the Council do not consider that the Provincial Medical and Surgical Association is pledged to su1pport the bill which may have been adopted by the con- ference of the medical associations in London, since some of the delegates appointed by their Council have not at- tended,* and others have resigned,t and the Council are ignoratt of the nature of the clauses of the proposed bill.Resolved,-That this CoseIl thipk it desirable that the reform proposed by the nmedical coiporations in London should be
Cocaine use and HIV infection in intravenous drug users in San Francisco
Authors: R. E. Chaisson
Journal: JAMA (1989)

We assessed risk factors for human immunodeficiency virus (HIV) infection in 633 heterosexual intravenous drug users. The HIV seroprevalence was 26% in blacks, 10% in Hispanics, and 6% in whites. Intravenous cocaine use significantly increased the risk of HIV infection, with a seroprevalence of 35% in daily cocaine users (odds ratio, 6.4; 95% confidence interval, 3.0 to 13.3). Black subjects were more likely to use cocaine regularly. Drug use in shooting galleries and sharing of drug injection equipment were also associated with HIV infection and were more common in cocaine users. By multivariate analysis, black race, daily cocaine injection by blacks and Hispanics, all other cocaine injection, heavy use prior to entry into methadone treatment by blacks, and use of drugs in shooting galleries were independent predictors of HIV infection. Methadone therapy was associated with substantial reductions in heroin use and some reduction in cocaine use, but 24% of cocaine users receiving methadone began or increased cocaine injection after entry into treatment. (<i>JAMA</i>1989;261:561-565)
An outpatient data system. New techniques to meet new demands
Authors: P. Y. Ertel
Journal: JAMA (1970)

A computer based outpatient data system, which is used in a major pediatric teaching hospital, was designed to simplify record keeping in a large decentralized clinic operation and to conserve professional time. Family and case demographic information and clinical data are collected as critical bits (selected and unduplicated input). Data acquisition forms serve as integrated components of the patient's record and as vehicles to enhance patient flow. Error surveillance programs, external reports, and internal reports for administrative purposes are generated at nominal cost. In a period of 21 months, the processing of more than 187,000 forms demonstrates the efficacy of the system.